|Learn how to conduct community assessments that cross administrative and jurisdictional boundaries.|
What do we mean by assessments that span jurisdictions?
Why arrange assessments that span jurisdictions?
Who should be involved in assessments that span jurisdictions?
When should you arrange assessments that span jurisdictions?
How do you arrange assessments that span jurisdictions?
What do we mean by arranging assessments that span jurisdictions?
In simplest terms, a jurisdiction is the area that a particular agency, branch of government, organization, educational institution, or other entity – or a particular office of one of these entities – is responsible for serving. Some examples of jurisdictions include:
- Public health service areas
- School districts
- Water districts
- Hospital, clinic, or other health provider service areas
- Areas served by particular offices of such (U.S. federal and state) government departments and agencies as welfare, Social Security, child protection, the Department of Agriculture , the Environmental Protection Agency, etc.
- Municipal and state police jurisdictions
- Court districts
- Legislative districts
- State or national borders
Jurisdictions can overlap in several ways:
- Similar entities (hospitals, community colleges) can have overlapping jurisdictions.
- The jurisdictions of different offices of a single entity – regional offices of the same state agency, for example, or legislative districts – can each include a different part of a region or community that is and/or sees itself as a unit, with coherent demographics, economics, politics, and social culture, as well as a coherent set of challenges, assets, and needs. In this case, the community overlaps the jurisdictions, rather than the other way around.
- As with the North Quabbin region above, services and government could be provided by multiple counties, school districts, offices of agencies, etc., so that there’s no rational system by which the whole community or area is served as a unit.
- In addition to coping with overlapping jurisdictions, you may want to compare – or to serve – communities that are legitimately separate, both administratively and otherwise, or to address a condition that seems to affect two or more such communities.
The key word in arranging assessments that span jurisdictions is “arranging.” When there are a number of players to deal with, many of whom may be protective of their “turf” – the area they’re responsible for and the funding that goes with it – it’s necessary to consult with everyone involved and ensure collaboration. Otherwise, you may find yourself unable to obtain information from some entities, or – worse – caught in the middle of a rivalry between two or more agencies or organizations, or even between offices of a single entity.
In other words, arranging assessments – or anything else – across jurisdictions can involve not only the logistics of getting and integrating data from many different sources, but tact and diplomacy as well. We’ll discuss both in the how-to part of the section.
Why arrange assessments that span jurisdictions?
The primary reason for conducting an assessment across jurisdictions is that it gives a clearer and more nearly complete picture of the assets, needs, and issues of an area that is divided administratively. There are, however, a number of other compelling reasons to conduct such an assessment:
- It gives more information to those serving the area. This, in turn, if used properly, will result in more effective use of resources, leading to better service delivery and better services for those who need them.
- It affords the opportunity to look at problems and issues as a whole, rather than focusing on a narrow geographical area. Many issues have causes and effects that extend across jurisdictional boundaries. Since these boundaries are artificial, constructed for the convenience of agencies, governments, etc. – it makes sense to cross them in trying to reach and address the root causes of conditions that need to be changed.
- It encourages agencies, institutions, and organizations to look at the area comprehensively, and to work together to serve it effectively. Again, this results in better allocation of resources and better services for the area.
- It can change the norms for how the area is assessed and served. By recognizing the area as a coherent whole that should be served in a coherent way, a cross-jurisdiction assessment can lead to the redefinition of administrative boundaries and a more rational pattern of service.
- It recognizes that administrative boundaries should follow community boundaries, rather than the other way around. In general, administrative boundaries exist for the convenience of the government agency, community-based organization, or institution that establishes them. In some cases, this can ignore the most reasonable way to provide services – the reason that the entity exists in the first place. This kind of assessment acknowledges the importance of the experience and circumstances that communities hold in common. That acknowledgment can lead to changes in policy by government and other entities to construct jurisdictions in ways that take the reality of communities into account.
- It encourages people in the area to view it as a unit, and to see themselves as members of a coherent community. That can improve relations among groups within the area, and help them work together to improve their community.
- It can bring out data that wouldn’t otherwise be visible. An assessment across jurisdictions can put together pieces of information that might not otherwise be shared or seen by more than one agency. This type of information can hold clues to the causes of issues or to unseen problems that can be tremendously important in understanding area needs.
Who should be involved in arranging assessments that span jurisdictions?
As in all the sections in this chapter, a priority here is including all sectors of the community in the assessment, and the resulting effort, from the very beginning. This may be especially important in assessments that span jurisdictions, because it emphasizes – for governmental and non-governmental agencies, organizations, and institutions – the need to consider local needs without regard for administrative boundaries. Some examples of groups that might be involved:
- Those directly affected by the issue(s) under consideration. These people may understand whom the issue affects and how, as well as the community’s actual boundaries and its context. These might in turn include youth, representatives of specific racial, ethnic, cultural, or socio-economic groups, and elders, as well as other concerned citizens.
- Local elected and appointed officials – mayors, municipal boards (health, recreation, and planning, etc.), city or town councils.
- Local government departments – public works, water, sewer, etc.
- Representatives of state and federal government and government agencies – state legislators, the Departments of Public Health, Welfare, Employment, Youth Services, Environmental Protection, etc.
- Non-governmental and community-based non-profit human service and charitable organizations that operate in the community.
- Administrators and staff of hospitals, clinics, and other private and public non-profit and for-profit health providers.
- School superintendents and other public and private school personnel.
- Local colleges and university administrators and faculty.
- The business community.
- Local and state police.
- The court system.
- Youth workers.
- Clergy and other representatives of faith communities.
- Community activists.
- Service clubs.
- Ethnic organizations.
When should you arrange assessments that span jurisdictions?
There are several times when cross-jurisdiction assessment is the best strategy.
When you’re serving a cohesive area that falls into several jurisdictions. When the area that you serve is in turn served in fragments by several others, you’ll have to work across jurisdictions to conduct a comprehensive – and accurate – community assessment.
When issues span jurisdictions. This can occur in at least two ways:
- A particular issue – the pollution of a river, for instance, or a health condition – or a particular population that an issue affects extends across a fairly wide region. In order to understand the seriousness of the issue, determine its cause, and address it, it’s necessary to collaborate with the various entities that serve the entire region. That may mean crossing municipal, county, or state boundaries, or collaborating with other agencies that do the same work in different geographical areas.
- The cause of an issue arises in a different area from the effects you’re concerned with. Youth in a rural area, for example, may be using heroin that they get in a city 20 or 30 miles away. In order to deal with the rural drug problem, it’s important to deal with the supply issue as well…and that means looking at the city as well as the urban area.
When you’re organizing a major initiative to address an issue. Few issues are confined to a single administrative jurisdiction. Risk and protective factors cross boundaries, and assessments must do the same if those factors are to be addressed. A cross-jurisdiction assessment of a shared issue can identify risk and protective factors that exist across a two or more areas, and lead to cross-jurisdiction strategies for dealing with them.
When you’re setting out to address social determinants or other root causes that are larger than any one jurisdiction. Poverty, discrimination, inequalities in education or economic opportunity – any of these is too big to tackle on a small scale.
When funders or laws mandate it. Non-profit hospitals in the U.S., for example, are required to conduct a Community Health Needs Assessment (CHNA) as part of maintaining their tax-exempt status. The areas such hospitals most serve cross many jurisdictional boundaries.
How do you arrange assessments that span jurisdictions?
As we indicated earlier in the section, it may take a certain amount of “arranging” – working with various agencies, branches of government, organizations, and institutions – to set up and conduct a cross-jurisdiction assessment. While vitally important, that’s only one – often the first, or among the first – of many steps that lead to a successful effort.
We’ll lay out a series of steps here, with the understanding that a community may change the order or the form of some to meet its own needs.
1. Engage the community and the entities whose jurisdictions are in question. Regardless of other concerns, this is almost always the first step in the process. The community and the entities whose jurisdictions are included in the assessment have to be involved from the very beginning, and should remain involved throughout the assessment, planning, implementation, evaluation, and maintenance phases of an effort to increase its chances of success.
“The community” here refers to all the kinds of individuals and groups identified in the “Who should be involved…?” part of the section – those affected by the issue(s) at hand, various community sectors, those responsible for addressing that issue, policy makers, those with the power to change conditions, those whose jurisdictions cover the area of concern, etc. A variety of strategies may be needed to engage a wide range of participants.
- For those most at risk of being affected by the issue – often, but not always, low-income or otherwise disadvantaged populations – community outreach is usually the most effective method. These folks may be best reached through social and religious organizations, health and human service providers, and word of mouth. Establishing relationships with respected members of the community who can introduce you to individuals and groups will help greatly here, especially when the population you want to reach is distrustful of outsiders.
- Members of the business community and community leaders can usually be reached through contacts you may already have with local officials and organizations. They can be contacted through the Chamber of Commerce, the local hospital, service clubs, educational institutions, a community coalition, etc. The likelihood here is that you have to be able to explain clearly what you want to do and why, and to define their role in the process to the extent possible.
Community members can be especially helpful in defining the community. They can also fill in the context – history, relationships, needs, etc. – that can be crucial to both the logistics of the assessment and your understanding of the community.
- Agencies, organizations, and institutions that work with the issue also need to be brought into the effort at the beginning. These include both those whose jurisdictions are in question and others for whom jurisdiction is simply not an issue (volunteer groups, for instance.)
- Entities whose jurisdictions overlap may need to be brought together to develop trust and to hash out how the assessment will be carried out. You or a neutral facilitator may have to help negotiate agreements about what each group will provide, do, or consent to. These agreements should also include clear guidelines for how the groups will work together and how they will settle any disagreements or conflicts that arise among them.
All of this is made easier by the existence of a community coalition of some sort. In some communities, the best strategy may be to start by putting together a coalition around the issue in question. Then, all the players are at the table to begin with.
2. Identify the intended uses of the data and the implications for jurisdictions that those uses imply. Why are you conducting this assessment? Some possibilities:
- Investigate the extent, seriousness, etc. of a particular condition in order to address it.
- Assess community needs in general or relating to a specific broad issue – health, violence, homelessness, etc.
- Identify social determinants of health.
- Comply with a law, regulation or funder’s requirement (as with the previously mentioned Community Health Needs Assessment required of tax-exempt hospitals).
- Rationalize service delivery and jurisdictional boundaries.
It’s important to understand and to be straightforward about what might happen as a result of your assessment. Depending on what the data will be used for, there could be effects on the various entities whose jurisdictions are involved. If they understand the possibilities and agree on them to begin with, the whole process will not only be easier, but whatever changes need to be made will go smoothly, rather than leading to conflict and potential long-term feuding. Some possible implications for entities and jurisdictions include:
- Memoranda of agreement among entities about how they will work together to address an issue or serve the area, and/or about how they will participate (and collaborate) in the assessment.
- Greater collaboration in general across jurisdictional boundaries.
- Changes in focus from dealing with specific issues to larger ones, such as social determinants of health or other conditions (or vice-versa).
- Redefinition of the area as a community or unit.
- Redefinition or renegotiation of jurisdictional boundaries.
3. Specify the geographic areas served by key stakeholders and the overlap among them. Because administrative boundaries are often different for different entities, the geographic areas served by various stakeholders can overlap and interlock in complex ways. Some of the obvious ways that they can be defined are by county, town, township, city neighborhood, or rural village or collection of villages. However, some other, less obvious ways, include:
- Distance from a central point. A hospital may define its service area as anywhere within 30 miles (50 kilometers), for instance, and that may intersect with the service areas of other hospitals.
- Watershed or ecosystem. This type of definition is often used for environmental protection or oversight.
- Area where a specific population lives. This may include parts of several city neighborhoods, a portion of a county or several counties, or, particularly in the developing world, a number of rural villages that may be grouped in a coherent area, or may be scattered widely among other villages that are not included in the jurisdiction.
- A public health, school, water, or other service district. These often conform to town, county, or similar boundaries, but in some places may be determined by geographical features, such as a river valley or mountainous area, or by the location of a regional office.
As we’ve described, overlap among jurisdictions can occur in a number of ways:
- Similar entities serving the same area.
- The area split among offices of a single entity.
- A coherent area served by different administrative districts of a variety of different entities – different counties, public health services, legislative districts, school districts, etc. – in ways that can make assessment and service delivery harder.
- Similar entities serving distinct areas, all of which are being targeted for a single assessment.
This overlap can also cause geographic complications, with a town or region divided not only among a number of different services, but among different offices of the agencies providing those services. It might be useful, if possible, to create a GIS (Geographic Information Systems) map of the area, with an overlay of a different color for each jurisdiction. The overlays in some sections might be five or more deep. These multiple-jurisdiction sections are the ones likely to require the most careful negotiation, to make sure all the stakeholders involved agree on how to work together.
4. Identify potential data sources and the geographic areas they represent. As with small area analysis, the geographic issues connected to cross-jurisdictional assessment can make data collection difficult. Some jurisdictions may be covered by a single data source for some types of information, but span multiple sources for others. Much of the following information on data sources is taken from Small Area Analysis.
- The census in the U.S. and other countries, in addition to counting people, gathers basic information on everyone and detailed information on a smaller number of individuals and families. Data on education, income, living conditions, employment, and numerous other categories are often available. You can search the census in a number of ways.
- By state or province, county, sub-county, city or town, parish, etc. Some census data are broken out by administrative districts, such as states or counties, and/or by community.
- Census tract. In the U.S. Census, all areas of the country are divided into census tracts. To the extent possible, all the households in a tract are similar in terms of demographics, economic status, and living conditions. A census tract has between 1,500 and 8,000 people, with the average at about 4,000.
- Census block. Census tracts are further broken down into blocks, smaller population units that may cover large geographic areas with few or no people, or – in metropolitan areas – may contain a single apartment house that is home to several hundred people.
- Organizational and institutional files often contain valuable information about health, living conditions, income, etc. The geographic areas they cover depend on where they draw their participants from. Some organizations and institutions that might be helpful include:
- Health and mental health clinics
- Human service organizations
- Schools and colleges
- Faith communities
- Environmental organizations
- Economic development organizations
Most of these in the U.S. protect the privacy of individuals, but may have general figures for the areas or populations they serve.
- Municipal records – the records kept by cities and towns and their departments and boards – can often be helpful. These obviously cover the specific municipality – town, city, metro area – they refer to. Among these might be:
- Police and court records
- Planning department files
- GIS and other maps
- Vital statistics (births, marriages, deaths)
- Municipal boards (Board of Health, Zoning Board, etc.)
- Water department
- Department of Public Works
- State and federal government agency files may be public records or may be available – again, with individual identities protected – for research purposes. They usually provide state- or province-wide figures, but may also include multi-state or national numbers, or may break down their statistics by county or town. Some that could prove useful:
- Welfare records
- BRFSS (Behavior Risk Factor Survey System – occasionally available for small areas
- YRBS (Youth Risk Behavior Survey), often broken out by school system or regional school district area
- The child protective system
- Public health data, both federal and state or provincial
- Environmental agencies or ministries
- Department of Transportation
- Employment/Unemployment agencies
- Agriculture departments or ministries
- Direct, hands-on information gathering can be effective when the areas you’re concerned with are small enough and you have the people – often volunteers – willing to go out and get the data. Some methods of direct data gathering:
Be aware that if you decide to gather your own data, volunteers or staff members will probably need some training, especially if they have no real experience of asking people for information or of research. How to find survey and interview subjects, how and when to make observations, effective recording techniques, the use of any special equipment – all of these and more may be part of a training for data collectors.
5. Identify potential community goals and target populations and how those affect the definition of the region covered in this assessment. Your goals may require stepping across geographic and administrative boundaries in order to conduct an accurate assessment. Some examples:
- If the assessment is aimed at exploring the extent to which HIV is spread through intravenous drug use in a rural area, nearby urban areas, where people buy (and often inject) their drugs, must be assessed also.
- Assessing the health and economic consequences of pollution in a river may mean examining areas far up- and downstream as well as those close by.
- Understanding broad social determinants – poverty, unemployment, racial discrimination – often means looking at causes that play out over a broad geographic area. Unemployment in a small town, for example, may have to be seen in terms of the county employment picture.
6. Describe features of the defined community and the broader context that affect the issue and efforts to improve it. What are the elements that define the community that you’ve lined out for assessment. They might include:
- Demographics: population size, age, gender, race/ethnicity, socio-economic status, education, employment, housing, crime, etc.
- Social determinants that intensify or moderate issues: income inequality, racial/ethnic discrimination, food security, access to health care and health information, social capital, physical safety.
- Nature and capacity of the community. This refers to community history – both in relation to the issue at hand and in general – relationships that encourage or discourage groups working together over the long term to change conditions, community leadership, community assets, and the ability of those in authority to actually effect change (i.e., the political and social clout to make things happen.)
7. Determine how well the available data fit with the geographic area you’ve defined. Data on demographics, health, crime, transportation, environmental issues, and other statistics are usually compiled by jurisdictions of some sort. When you’re crossing jurisdictions – especially when you’re considering only parts of two or more jurisdictions – it can be difficult to obtain figures for the specific area you’re concerned with. You may have to estimate some numbers, based on data you have, or put together numbers from several different sets of data in order to get information you can use.
The first step here is to decide on the indicators you want to use to assess the situation. Some may be obvious: if you’re concerned with teen pregnancies, then the number of teen pregnancies in your defined area will clearly be an indicator you’ll want to use. Other indicators may be less obvious, and more difficult to track across jurisdictions. The best course, if there is no information that matches the area of concern, is to try to extract statistics for parts of the jurisdictions you’re dealing with that match the total area in terms of demographics, geography, and other significant characteristics.
If you simply can’t get the data you need on particular indicators, you have some choices. You can find other indicators for which you can collect data that will give you the same or equivalent information; you can estimate baseline indicator numbers from the data you do have; or, if you have the time and resources, you can try to collect the data directly from the community. Whatever method you use, you’ll probably want to compare your data to statewide or other statistics so that you can determine the level of the needs and assets of your area of concern.
8. Maintain cross-jurisdictional alliances and collaboration, so that you can continue to monitor the area in the future. If, as is likely, your assessment results in an effort to create positive change, you’ll have to continue to work across jurisdictions. Maintaining the agreements and collaborative arrangements among all the stakeholders that you engineered in order to conduct the assessment will make your effort possible, and greatly increase the likelihood that it will have some permanent effect.
Sometimes, it’s necessary to conduct a community assessment that crosses administrative and jurisdictional boundaries. That can occur when a coherent community is split among several jurisdictions or when an issue transcends jurisdictions. In either case, it’s important to help all the stakeholders come to agreement about their parts ion the assessment, how they will collaborate, and what will happen when the assessment is done. In order for that to happen, there may need to be some negotiation, facilitated by a neutral party, leading to memoranda of agreement that define relationships among the stakeholders and lay out what each agrees to do. It’s also important to think out and discuss the possible consequences to these entities of operating across jurisdictions, since it could lead to the redrawing of administrative boundaries, or to new agreements about how a region is served.
In addition to those organizations, agencies, and institutions whose jurisdictions are in question, it’s important to involve all segments of the community, particularly those most affected by the issue at hand, in planning and carrying out the assessment and any subsequent action.
Cross-jurisdiction assessments can be particularly useful when the goal is to understand and address social determinants of health or other conditions. The difficulty, however, may be in gathering data, since only parts of various administrative districts may be involved. There may be a need to pull data from a variety of sources and make some educated guesses about how the information fits together.
A final step in the process is to maintain relationships among the entities involved, so that cross-jurisdictional collaboration either becomes standard operating procedure, or can be revived whenever needed.
We encourage the reproduction of this material, but ask that you credit the Community Tool Box: http://ctb.ku.edu/.
Some recommended practice areas for community health improvement is a report to the CDC, Office of Prevention Through Healthcare from 2011, by the Center for Community Health and Development, University of Kansas.
Association for Community Health Improvement. Step 2: Determine the Purpose and Scope of the Community Health Needs Assessment. Community Health Assessment Toolkit.
National Association of County and City Health Officials. (2001.) Phase 3: Four MAPP Assessments, Community Health Status. Mobilizing for Action through Planning and Partnerships: Web-based Framework Tool. Washington, DC: National Association of County and City Health Officials.
Association for Community Health Improvement. Step 2: Defining the Purpose and Scope. Community Health Assessment Toolkit.
National Association of County and City Health Officials. (2008). Task 4: Define the Goals of the Assessment. Protocol for Assessing Community Excellence in Environmental Health.
Substance Abuse and Mental Health Services Administration. Step 1: Identify the goals of the needs assessment. Community Needs Assessment Guide. U.S. Department of Health and Human Services.